NEWS BLOG from UPMC and the University of Pittsburgh Schools of the Health Sciences

UPMC Mercy Celebrates Comprehensive Stroke Center Designation

UPMC Mercy Celebrates Comprehensive Stroke Center DesignationUPMC Mercy is starting 2018 as a Joint Commission-accredited Comprehensive Stroke Center. The hospital was the 130th facility out of approximately 6,000 in the nation to achieve the highest level of certification offered by The Joint Commission, which acknowledges UPMC Mercy’s ability to treat the most complex stroke cases.

Previously, UPMC Mercy was a Joint Commission-accredited Primary Stroke Center, which recognized the hospital’s stroke program and its efforts to improve stroke treatment and outcomes. In 2015, UPMC Mercy made the choice to pursue the advanced certification.

“To make this new Comprehensive Stroke Center designation a reality, we committed the resources necessary to enhance our overall stroke care competencies, and the team dedicated two years to the rigorous process that was required to achieve the certification,” said Michael Grace, president of UPMC Mercy.

Advancing from a Primary to a Comprehensive Stroke Center required UPMC Mercy to expand its round-the-clock medical services, develop dedicated neurovascular intensive care unit beds, conduct additional training for staff, collect medical data and increase existing stroke resources. The hospital also improved its processes to care for a larger number of stroke patients.

“Becoming a Comprehensive Stroke Center required support from all areas of our hospital, from the emergency department to rehabilitation services and everything in between,” said Dr. Ashutosh Jadhav, UPMC Mercy Stroke Service medical director. “This certification was a true group effort that has resulted in higher quality care for the patients we treat.”

As the home of the UPMC Rehabilitation Institute, which includes a dedicated stroke rehabilitation unit, UPMC Mercy is now in a unique position to provide care for patients throughout their entire stroke treatment and recovery process. Patients have access to advanced diagnostic capabilities and state-of-the-art neurovascular technology.

Visit the UPMC Mercy website for additional information about the hospital’s stroke services. To make an appointment, call 412-232-8840, and to learn about monthly support groups, call 412-232-8738.

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Pitt Scientist Sets Sights on Gene Editing to Improve Vision

Pitt Scientist Sets Sights on Gene Editing to Improve VisionInherited retinal degeneration affects about one out of every 2,000 people worldwide and severely impacts quality of life. Due to mutated genes, this disorder causes blindness and currently has no treatment.

To solve this problem, University of Pittsburgh researchers are developing gene therapy solutions to replace the malfunctioning genes with normal, healthy genes, or to rewrite sections of mutated DNA using CRISPR/Cas9 genome editing tools.

Dr. Leah Byrne from the Pitt School of Medicine is developing these gene therapy solutions with support from a competitive $300,000 Career Development Award from Research to Prevent Blindness (RPB).

One way to replace malfunctioning genes with normal ones is to ferry the good genes into the patient within harmless or inactivated viruses. The Byrne lab will use the grant to create adeno-associated viral (AAV) vectors and delivery systems for the expression of genes that don’t fit into currently available viruses, and for efficient delivery of genome editing tools in the body.

“This research will benefit millions of patients worldwide who are affected by a wide variety of forms of inherited retinal degeneration,” Byrne said. “We’re developing gene delivery methods that have the potential to impact gene therapies for any form of inherited disease.”

Since it was founded in 1960, RBP has channeled more than $355 million into eye research, and has been identified with nearly every major breakthrough in vision research.

“In my lab, we aim to directly address the most significant obstacles preventing clinical translation of gene therapies,” Byrne said. “This grant will help further our research.”

For more information on RPB’s grants program and findings generated by these awards, visit www.rpbusa.com.

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Pitt Team Receives Grant to Improve Prosthetics Through Sensory Feedback

Pitt Team Receives Grant to Improve Prosthetics Through Sensory FeedbackTactile senses keep people aware of their environment and are essential for the execution of natural movement. Though there have been many advances in modern prosthetic devices, the loss of sensory feedback remains an issue, and many amputees struggle with everyday movement. Lack of sensory feedback in transtibial (below-knee) amputation means that the prosthesis user must rely on their residual limb for all motor skills. Patients suffer with problems in balance control, risk of falling, and severe phantom limb pain.

A University of Pittsburgh group seeks to address this need for sensory feedback in prosthetic devices.

Dr. Lee Fisher, assistant professor of physical medicine and rehabilitation, and Dr. Doug Weber, associate professor of bioengineering, were one of four Pitt teams to receive a $5.3 million National Institutes of Health (NIH) BRAIN award.

The NIH Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative aims to advance understanding of the human brain. Fisher and Weber won an award in the “Next Generation Human Invasive Devices” category for their project titled “Spinal root stimulation for restoration of function in lower limb amputees.”

“Evidence suggests that lack of sensory feedback contributes to phantom limb pain [PLP], a phenomenon where amputees feel pain from the missing limb, which can be long-lasting and severe,” Fisher said. “We’ll be investigating how electric stimulation may both counter PLP and improve movement and balance.”

The team’s objectives are to explore the effects of electrically stimulating the dorsal root ganglia and dorsal rootlets to generate sensations and reduce phantom limb pain, characterize the responses to electrical stimulation in both the intact and amputated limbs to coordinate reflexes and improve movement, and use electrical stimulation to decrease postural sway and increase gait stability.

Fisher and his team will use an FDA-cleared spinal cord stimulator to send electrical pulses to the dorsal root ganglia (DRG) and dorsal rootlets (DR) in hopes of reducing PLP. The stimulation creates sensations of pressure and movement in the amputated limb, thereby reducing PLP and improving prosthesis functionality.

The group will use the same electrical stimulation to characterize reflexive responses. Electromyography will be used to measure reflex responses generated in the muscles of the leg.  Having bilaterally coordinated reflexes will help prosthetic users when responding to unexpected situations, such as slips or falls. Being able to precisely control the patterns of reflexive activity will also help with everyday standing and walking.

The team will be using pressure sensitive insoles and joint angle sensors in the prosthetics.

“The insoles allow us to control stimulation,” Fisher said. “If we record increased pressure under the ball of the foot, we will increase stimulation for an electrode that generates a sensation at the ball of the foot. The goal is to make it feel like the sensations are coming from the prosthetic limb.”

The study of these signals and modulation of sensory feedback through DRG/DR stimulation should improve movement by decreasing postural sway and increasing gait stability.

Making improvements in the sensory feedback of prosthetic devices could drastically improve the quality of life for their users by reducing phantom limb pain, increasing balance control and confidence, and making the prosthetic limb feel more natural, added Fisher.

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